Doctor Name: | THEODORE R CORWIN |
NPI Number: | 1073683405 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | G29196 |
Business Practice Address: | 911 Hampshire Rd Suite 1 Westlake Village, CA - 913612818 |
Business Phone Number: | 8054943656 |
Business Fax Number: | 8057789104 |
Mailing Address: | 911 Hampshire Rd, Suite 1 WESTLAKE VILLAGE |
State: | CA |
Postal Code: | 913612818 |
Phone Number: | 8054943656 |
Fax Number: | 8057789104 |
NPI Enumeration Date: | 11/09/2006 |
NPI Last Update Date: | 03/30/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0122X |
License Number: | G29196 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Plastic and Reconstructive Surgery |
Taxonomy Definition: | A surgeon who specializes in plastic and reconstructive surgery. |